EFFECT OF SPECIMEN COLLECTION TECHNIQUES, TRANSPORT MEDIA, AND INCUBATION OF CULTURES ON THE DETECTION RATE OF HELICOBACTER-PYLORI

Culture and histologic examination are considered ''gold standard'' me thods for the detection of Helicobacter pylori, but discrepancies may occur with either method. Failure to detect Helicobacter pylori may be due to sampling error, inappropriate transport or culture media, or i nsufficient duration of the incubation period, Rates of detection of H elicobacter pylori by culture and histopathologic examination of gastr ic mucosal biopsy specimens were determined in 102 consecutive dyspept ic patients. In a separate group of 60 patients, rates of detection of Helicobacter pylori by culture of antral brushings and the length of incubation required in selective and nonselective culture media were s tudied. In the first group of 102 patients, the combination of culture and histologic examination detected 54 Helicobacter pylori-positive p atients, whereas the separate techniques each detected 51 Helicobacter pylori-positive patients. In the second group of 60 patients evaluate d by culture of antral brushings, the rate of detection of Helicobacte r pylori was 25 of 60 and was similar for culture (25/60) and histolog ic examination (25/60). In the second group the length of incubation r equired to detect Helicobacter pylori was different for selective and nonselective media, In nonselective media, incubation of up to ten day s was required to detect all Helicobacter pylori infections, whereas i n selective media seven days was sufficient. Rates of detection of Hel icobacter pylori by culture, histopathologic examination and culture f rom brushings were similar, whereas the combination of culture and his topathologic examination achieved a superior rate of detection. The in cubation period required for the detection of Helicobacter pylori by c ulture was a minimum of seven days and was dependent on the culture me dium used.